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Individual
DR. MICHAEL E ROTH
Active
Individual
DR. MICHAEL E ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1272
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121586504
—
TX
01
—
480034724
MEDICARE RAILROAD
—
01
—
83000G
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/04/2006
Last updated
11/01/2022
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